The World Health Organization says around 40 million people globally are living with HIV, the virus that causes AIDS. As the numbers continue to grow, a recent conference sponsored by the Center for Strategic and International Studies emphasized the need to focus more attention on prevention.
When it comes to HIV/AIDS, treatment of the victims of the disease has historically gotten more attention than prevention. "Of course, it's very challenging to understand and measure something that did not happen, which is ultimately the goal of prevention. It's much easier to count pills, to count people reached with treatment, than it is to measure behavior change and measure averted infections," said Jennifer Kates, HIV policy director for the non-profit health organization, Kaiser Family Foundation. She said health experts cannot curtail the global AIDS epidemic overall without also working to prevent the spread of the disease in five populous countries, China, Ethiopia, India, Nigeria and Russia.
"The HIV/AIDS epidemics within these countries are at different, but critical, tipping points. And, by tipping points, I don't mean epidemiologically, but I mean politically and strategically, so that the decisions that are made today around HIV prevention scale-up will have dramatic implications for the course of the epidemic, as well as the societies overall and the global epidemic, as I mentioned earlier," she said. Ms. Kates spoke at a recent conference organized by the Center for Strategic and International Studies HIV/AIDS Task Force.
CSIS president John Hamre said his hope was that the meeting, which brought together officials from the five countries, would provide a forum for them to openly share experiences with each other. "What really becomes an ingredient that makes a crucial difference is when political leaders make that transition for a society to take this disease away from being a pariah disease, because it tends to hit people whom society would like to marginalize anyway, and make it an agenda for the country, because it becomes a basic health concern for the country, and not just for a vulnerable minority," he said.
These marginalized populations include commercial sex workers, intravenous drug users and homosexual men.
Indian Health Minister Anbumani Ramadoss said 85 percent of his country's approximately five million HIV cases are sexually transmitted. He said because Indian society is conservative, it needed "a little pushing" to get people to deal with the problem. "Coming to the stigma and discrimination which is there, rampant in India, I accept that there is a lot of discrimination at workplaces, at treatment places, at schools, the young kids are turned away. And the government of India now is going to enact a legislation on that front, and we are on the way with drafting it," he said.
He said the Indian government hopes to have the anti-discrimination legislation ready by the end of the year. Mr. Ramadoss also called for more attention to developing and promoting vaccines. "We have done away with small pox because we had a vaccine. We are doing away with polio because we have a vaccine. We have to do away with HIV, only if we have a vaccine," he said.
India's prevention efforts also include a promotional campaign on the use of condoms and incorporating AIDS into the plot lines of various popular television programs.
Another populous country with a growing AIDS problem is China. "The central government of China shows strong political commitment," said Chinese Vice Health Minister Wang Longde. "We have been working on the regulation for AIDS prevention and control. The regulation is expected to be issued by the State Council at the end of this year," he said.
The United Nations puts the number of Chinese infected with HIV at about 840 thousand, out of a population of about one-point-three billion people. Mr. Wang said most of the HIV cases in China are either intravenous drug users or commercial blood donors. He called China "a beginner" in the field of AIDS control, and said the Chinese government is working hard to combat the stigma of the disease.
The Kaiser Family Foundation's Jennifer Kates said these two Asian giants, along with Ethiopia, Nigeria and Russia, are critical in the global battle against HIV/AIDS. "So, what happens in these countries, what the U.S. and other donors, and what these countries do on their own to respond to HIV, will have serious implications for the global epidemic beyond their borders," she said.
Ms. Kates acknowledged that different countries may have their own definitions of AIDS prevention, and that discussions of the issue can be polarizing. But she added that she is encouraged that the five countries have recognized their own HIV/AIDS problems, and are starting to take steps to deal with them.